Healthcare Provider Details

I. General information

NPI: 1740494574
Provider Name (Legal Business Name): JEFFREY D PIPER MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 W PINE BLVD
SAINT LOUIS MO
63108-2186
US

IV. Provider business mailing address

4500 W PINE BLVD
SAINT LOUIS MO
63108-2186
US

V. Phone/Fax

Practice location:
  • Phone: 314-361-5983
  • Fax:
Mailing address:
  • Phone: 314-361-5983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2002024646
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: